A review of the psychological literature reveals that only a very small percentage of psychotherapy services in the United States are tightly linked to existing scientific knowledge. It is a really quite strange if you think of it. Would anyone want undergo medical surgery that was not based on a current scientific understanding of the body? Ask yourselr: just why should the mind and behavior be any different?
It is clear that this problem has multiple faces. Psychology and psychiatry have historically had a really hard time agreeing on what we even mean by mental disorders. Clearly, there is a proliferation of theories and approaches. Everyone seems to have some strange theoretical axe to grind. Managed care companies have strident practice guidelines; yet, it is infuriating that often such “guidelines” just come down to ways to reduce cost. The American Psychiatric Association has practice guidelines, but medications are so emphasized (no surprise) that as a broad public information service, they are not very useful.
This problem has multiple faces for psychology and psychiatry. Scientists have had a hard time agreeing on what we even mean by mental disorders. There clearly is a proliferation of theories and approaches. Everyone seems to have an axe to grind. Big pharma and managed care companies have practice guidelines but often they just come down to ways to reduce cost. The American Psychiatric Association has practice guidelines, but medications are so emphasized (surprise) that as a broad public information service, they are not very useful.
One certainly might hope that the government could get reasonable scientists together to say what is known. The fact that economic interests sometimes want a particular answer can make that difficult as well. But there are at least two government efforts worth noting in the area of psychotherapy, and fortunately both are exploring acceptance and mindfulness-based alternatives in the area of evidence-based care that give consumers a wider range of choices.